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LeadingAge Ohio urges technical fix to avoid Medicaid cuts for nursing facilities
Summary
LeadingAge Ohio told the Senate Finance Committee a change tied to CMS's PDPM case-mix system would produce an effective, immediate cut to nursing facility reimbursements unless the General Assembly adopts a statutory conversion fix; the group proposed amendment SC2858 to the omnibus budget.
Chair Serino and members of the Senate Finance Committee heard detailed testimony from Susan Wallace of LeadingAge Ohio on a technical reimbursement problem the group says is embedded in the budget language for nursing facilities. Wallace told the committee the change moves Ohio from RUGS-based case-mix scoring to the PDPM system used by CMS and that, without a statutory conversion factor, providers will see an immediate funding reduction.
"For this piece, we would advocate for it being changed immediately because it would be an immediate, effective cut," Wallace said, urging senators to add a legislative fix. She said the group is asking the committee to include amendment SC2858, a "technical fix" that would allow the Department of Medicaid to translate PDPM scores into a funding level comparable to the RUGS-era…
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